上鼻道原発の巨大な鼻茸症例—内視鏡下の切除法

A Large Nasal Polyp Originated from the Superior Meatus: Surgical Excision under Endoscopy

　Ⅰ．はじめに

　鼻腔に発生する鼻茸は有茎性の粘膜ポリープであり，日常診療にしばしば遭遇する疾患であって，必ずしも稀有な疾患でない。そして大部分の鼻茸は中鼻道に茎をもつことが多いようである。しかし時に中鼻道以外の鼻粘膜から発生した鼻茸の症例が報告されている（西端ら^1））。最近われわれは上鼻道に茎をもつ鼻茸の症例を経験した。鼻茸は鼻腔から中咽頭におよぶ大きなものであった。われわれは鼻腔用硬性内視鏡直視下に茎を切断し，容易に治癒せしめたので，ここに症例を供覧し，諸賢の参考に供する次第である。

　A large nasal polyp originated from the superior meatus in a 47-year-old man who visited our clinic, complaining with right nasal obstruction, snoring and nasal speech was reported. He had noted those symptoms about two years ago. The examinations showed that the large mass occupied in the right nasal cavity and in the oropharynx behind the uvula, suggesting existence of the large mass in the nasal cavity and pharynx. Endoscopic examinations revealed that the mass originated from the superior meatus. The surgical excision of the mass was done through an endoscope. The narrow band between wall of the superior meatus and the mass was cut with a modified curette, which was attached to the tip of endoscope with a connector. Then the mass was taken off from the pharynx. Histopathological examination showed a nasal polyp with abandunt glandular elements. Those findings were discussed briefly.